Subcutaneous gluteal migration of hardware after spine fusion: A case report

Background: Rod fracture is a well-recognized late mechanical complication following long-segment posterior instrumentation in adult spinal deformity. However, rod fracture with distant migration is rare. Here, a 52-year-old female presented 15 years following a T10-sacrum fusion with a subcutaneous gluteal mass representing migration of a fractured rod fragment. Case Description: A 52-year-old female had a posterior instrumented fusion from T10-sacrum performed 15 years earlier for thoracolumbar scoliosis. She presented with progressive pain and a palpable mass in the left gluteal region (firm subcutaneous prominence with focal cutaneous ischemic necrosis). X-rays demonstrated a 10-cm detached segment of the left longitudinal rod with caudolateral migration into the gluteal tissue; the prior fusion was intact. The patient fully recovered following fragment removal under local anesthesia. Conclusion: Late rod fracture with distal migration should be considered in the differential diagnosis of soft-tissue masses in patients with prior long-segment spinal instrumentation. Prompt surgical resection should be performed to avoid skin perforation/infection.